Tuberculosis As old as recorded history Symptoms described in
the Rig Veda (1500 BC) Unequivocal lesions in Egyptian mummies
Odier, Ford described meningeal TB 1790 Surgical excision Wernicke
and Hahn 1882, 3/11/2010 CNS tuberculosis imaging and surgery
2
Slide 3
Tuberculosis CNS tuberculosis complicates 10% of all TB Never
the first manifestation Occurs within 6-12 months Circle of Willis
more frequently involved than the basilar system 3/11/2010 CNS
tuberculosis imaging and surgery 3
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Mycobacterium tuberculosis Acid fast bacillus Does not stain on
gram stain Obligate aerobes Difficult to grow High lipid in cell
wall Hominis/ Bovine/ Avium 3/11/2010 CNS tuberculosis imaging and
surgery 4
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Pathogenesis May develop during initial infection/ reactivation
Haematogenous dissemination Commonest Focus in brain (Rich focus)
Rupture of focus into subarachnoid/ ventricular space Contiguous
spread 3/11/2010 CNS tuberculosis imaging and surgery 5
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CNS tuberculosis Intracranial Parenchymal Meningeal Osseous
Spinal Parenchymal Meningeal Arachnoiditis Osseous 3/11/2010 CNS
tuberculosis imaging and surgery 6
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Epidemiology Incidence varies blacks > whites Predominantly
in the young (50%